improvement of a physically active lifestyle

Conditions: Pain; Osteoarthritis; Rheumatoid Arthritis; Heart Diseases; Diabetes Mellitus, Type 2; Behavior; Motivation

Summary: to help rehabilitation patients to adopt and maintain a physically active lifestyle, it is imperative to increase self-management competencies. aim of this research project is to evaluate an evidence- and theory-based computerized expert system in comparison to a well established standard program and a questionnaire-only group. rehabilitation patients will be treated psychologically and followed up over 18 months. the computerized expert system is expected to help patients better than the standard program. both interventions are hypothesized to improve self-management competencies over and above the rehabilitation treatment (i.e., questionnaire-only group).

an experimental study with three groups is planned over a time period of 18 months. patients in the intervention group receive an interactive, computerized expert system (intervention group, ig). patients in the active control group (acg) get an interactive computerized standard program. this standard program has already been proven to be effective but which does not tailor treatment components to the individual needs of the patients. patients in the passive control group (pcg) are asked to answer the questionnaires only. rehabilitation patients (n = 1000) will be recruited in three rehabilitation clinics and followed up over six measurement points: t1 and t2 with computer interventions during their rehabilitation stay; t3 and t4 with booster-sessions via telephone (6 weeks and 6 months after admission from rehabilitation). furthermore, patients will be contacted at t5 per mail with motivational material (12 months after admission) and at t6 again per mail (only questionnaire, 18 months after admission). the hypotheses are: in comparison to the pcg, both the ig and the acg are expected to have a higher motivation, to adopt a healthy lifestyle, to perform more health behavior and to be less likely to relapse into previous unhealthy routines. also, ig and acg will be healthier as well as they will report more quality of life and rehabilitation satisfaction. in comparison to acg, the ig is hypothesized to be more effective than the acg regarding motivation, behavior and social-cognitive predictors of behavior. moreover, the interventions (acg and ig) are supposed to be equally effective for cardiac and orthopedic, as well as out-patient and stationary treated rehabilitation patients. after successful evaluation and some adoptions the intervention will be implemented as a self-help program in all eligible rehabilitation clinics and in the internet.

Eligibility criteria:
inclusion criteria: * to be capable of exercising on their own at the minimum level recommended by the according rehabilitation clinic * able to fill out a questionnaire (no illiteracy) * adequate german language ability exclusion criteria: * the participant not be of age * severe cognitive deficits * visual impairments (patients have to read at the pc)

Keywords: randomized controlled trial evidence- and theory-based behavioral intervention expert system stages of change motivational interviewing tailoring self care rehabilitation expert systems